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IRS.gov Website
Instructions for Form 8965
taxmap/instr/i8965-005.htm#en_us_publink100032286

Specific Instructions

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taxmap/instr/i8965-005.htm#en_us_publink1000280068

Part I — Marketplace-Granted Coverage Exemptions for Individuals(p5)

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If you or another member of your tax household has been granted one or more coverage exemptions from the Marketplace, or has an application for a coverage exemption pending with the Marketplace, complete Part I to report these exemptions. Complete a line for each individual who was granted or has a pending application for a Marketplace-granted coverage exemption. If an individual was granted or has a pending application for more than one coverage exemption from the Marketplace, complete a separate line for each coverage exemption for that individual. If you need more space, attach a separate statement showing the information required in columns (a) through (c) for each additional coverage exemption.
taxmap/instr/i8965-005.htm#en_us_publink100032547
Coverage exemptions that apply to multiple years.(p5)
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If you were granted a coverage exemption that applies for multiple years, you must report the coverage exemption on Form 8965 every year it applies. See Duration under Members of certain religious sects and Members of Indian tribes, later.
taxmap/instr/i8965-005.htm#en_us_publink10005870

Lines 1–6(p5)

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taxmap/instr/i8965-005.htm#en_us_publink10006657

Column (a)—Name of Individual(p5)

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Enter the name of each person in your tax household who was granted a coverage exemption from the Marketplace or has an application for a coverage exemption pending with the Marketplace. If the individual is listed on page 1 of your tax return, enter the name exactly as it appears on your tax return.
taxmap/instr/i8965-005.htm#en_us_publink10006658

Column (b)—Social Security Number (SSN)(p6)

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Enter the SSN of the individual listed in column (a). If the individual is listed on page 1 of your tax return, the SSN in this column should match the individual’s SSN listed on your tax return.
taxmap/instr/i8965-005.htm#en_us_publink10006659

Column (c)—Exemption Certificate Number (ECN)(p6)

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Enter the ECN that you received from the Marketplace for the individual listed in column (a). If you were granted a coverage exemption from the Marketplace, but didn't receive an ECN, or don't know your ECN, contact the Marketplace to obtain your ECN. If the Marketplace hasn't processed your application before you file, enter pending.
taxmap/instr/i8965-005.htm#en_us_publink100014348
Members of certain religious sects (enter ECN).(p6)
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An individual may claim a coverage exemption for members of recognized religious sects only if the Marketplace has granted the individual an exemption. A recognized religious sect is a religious sect in existence since December 31, 1950, that is recognized by the Social Security Administration as conscientiously opposed to accepting any insurance benefits, including Medicare and social security.
taxmap/instr/i8965-005.htm#en_us_publink100032548
Duration.(p6)
If a member of your tax household was granted a coverage exemption as a member of a religious sect, you must report it on Form 8965 every year it applies. Once the Marketplace grants an individual this exemption, it generally applies each year unless the individual reports to the Marketplace that he or she no longer qualifies for the coverage exemption. However, for an individual granted the exemption before his or her 21st birthday, the exemption applies only until the first full month following the individual's 21st birthday. After that, the individual must apply to the Marketplace again for the exemption.
taxmap/instr/i8965-005.htm#en_us_publink100032549
Hardship exemptions.(p6)
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In addition to the coverage exemption for members of recognized religious sects, certain hardship exemptions also may be granted only by the Marketplace. See the Types of Coverage Exemptions chart.
taxmap/instr/i8965-005.htm#en_us_publink100032550
Members of Indian tribes.(p6)
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If a member of your tax household was granted a coverage exemption as a member of an Indian tribe you must report it on Form 8965 every year it applies. It applies until the individual reports to the Marketplace that he or she no longer qualifies for the coverage exemption.
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Members of a health care sharing ministry, members of Federally-recognized Indian tribes, individuals eligible for services from an Indian health care provider, and incarcerated individuals may have been granted a coverage exemption from the Marketplace or may claim a coverage exemption on their tax return. If you received one of these coverage exemptions from the Marketplace, follow the instructions for Part I to report your exemption. If you didn't receive a coverage exemption from the Marketplace and qualify to claim one of these exemptions on your tax return, see the instructions for Part III, later.